Comparative Safety and Effectiveness of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in Obese Elder Patients: a Systematic Review and Meta-analysis

Purpose This study aimed to compare the safety and effectiveness of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in patients aged 60 years old or older. Methods The available literature was searched for eligible studies up to November 2019. The meta-analysis was performed by the RevMan 5.3 software. Results This meta-analysis involved nineteen studies. The rates of early and late complications in RYGB were much higher than those in SG. More specifically, within 30 days after surgeries, leak, urinary tract infection, obstruction, and death occurred more often in the RYGB group. The above differences may lead to higher rates of hospital readmission and return to the operating room. RYGB was superior to SG in terms of remission of hypertension and the 1-year follow-up weight loss outcome, while there were no differences in terms of remission of type 2 diabetes (T2D) and obstructive sleep apnea (OSA) as well as weight loss outcomes during 2- and 3-year follow-up. Conclusions SG was the preferable option to RYGB for patients aged 60 years old or older, as SG has been shown not inferior to RYGB in terms of effectiveness, while being safer than RYGB.